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目的 探讨结肠癌浸润转移的病变机制。方法 采用免疫组织化学 L SAB法检测 30例正常结肠组织及 82例结肠癌标本中胶原 (Col) 、层粘连蛋白 (L N)、纤维粘连蛋白 (FN)的表达。结果 30例正常结肠组织的腺体周围基底膜结构均匀、完整 ,基本无间质增生。 82例结肠癌组织中腺体周围基底膜结构遭到明显的破坏 ,呈断线状、条索状、甚至碎片状表达 ,且有不同程度的间质增生。 Dukes C/ D期 (5 3.7% )和低分化 (37.8% )的结肠癌组基底膜明显缺损和间质明显增生程度大于 Dukes A/ B期和中高分化的结肠癌组 (P均 <0 .0 5 )。术后0 .5 a内死亡组 (19.5 % )基底膜明显缺损重于 0 .5～ 5 a及 5 a以上生存组 (P均 <0 .0 5 ) ,而间质明显增生在三组间差异无显著性 (P均 >0 .0 5 )。结论 结肠癌恶性程度的高低与其腺体周围基底膜结构是否完整有必然联系 ,其浸润转移首先破坏基底膜。细胞外间质纤维组织的增生一方面可为癌细胞的浸润生长提供依托 ,另一方面也反映了机体对抗和限制肿瘤转移的一种趋势。提示 Col 、L N、FN的免疫组织化学检测可以作为临床判断结肠癌恶性程度、淋巴转移趋势及评估其预后的有价值指标。
Objective To investigate the pathological mechanism of invasion and metastasis of colon cancer. Methods Immunohistochemical L SAB method was used to detect the expression of collagen (Col), laminin (L N) and fibronectin (FN) in 30 normal colon tissues and 82 colon cancer specimens. Results The basement membrane structure around the gland of 30 cases of normal colon was uniform, complete and basically without interstitial hyperplasia. 82 cases of colon cancer tissue around the glandular basement membrane structure has been significantly damaged, was broken line, cord-like, or even fragments, and have different degrees of interstitial hyperplasia. Dukes C / D stage (53.7%) and poorly differentiated (37.8%) colon cancer group was significantly larger than that of Dukes A / B stage and moderately well-differentiated colon cancer group (P <0.05). 0 5). The significant defect of the basement membrane in the dead group (19.5%) within 0.5 days after operation was more than 0.5-5 days and more than 5 years (P <0.05), while the interstitial hyperplasia was found between the three groups There was no significant difference (P> 0.05). Conclusion The degree of malignancy of colon cancer is closely related to the integrity of the basement membrane structure around the gland. The invasion and metastasis of the tumor first destroy the basement membrane. The proliferation of extracellular matrix fibrosis on the one hand can provide support for the infiltration of cancer growth, on the other hand also reflects the body confrontation and limit the trend of tumor metastasis. It is suggested that the immunohistochemical detection of Col, LN and FN can be used as a valuable index to judge the degree of malignancy, lymph node metastasis and evaluate the prognosis of colon cancer.